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Best way to explain the 6/8am rule for overnights?

Discussion in 'Pharmacy' started by Charcoales, Sep 11, 2017.

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  1. Charcoales

    Charcoales 5+ Year Member

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    Do you say something like we don't fill them until 8am since our system doesn't consider it a new day until 8am for the purposes of the day early policy?
     
    Last edited: Sep 11, 2017
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  3. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    What, for narcs?

    I just fill them at midnight. It's irrelevant. Whatever time you tell them, they'll all show up at exactly that moment. I'd rather have 3 people stumble up at 12AM with narcs with no other business to attend to than at 8AM with narcs when there is other business to attend to.
     
  4. KimChiSlap

    KimChiSlap

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    maybe exclude Sunday 12am
    insurance issues then =[
     
  5. zelman

    zelman 7+ Year Member

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    Either fill when their insurance thinks it's the appropriate date, or when the prescriber's office is open if you need to talk to them. If you're too busy at midnight, just give an appropriately long wait time.
     
  6. maria1oh

    maria1oh 7+ Year Member

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    Just tell them out of stock.

    The rule is usually made by the PIC or Sup so ironically they would get mad if I ever filled a narc at midnight. I tried explaiming to PIC filling at midnight would make it easier for her in the morning and she refused saying the policy is corporate not hers.

    I was always busy around midnight being nearby emergency rooms. Also the readyfills drop in at midnight and PIC expects those done by morning shift. Not to mention my last tech went home at midnight.

    Also simply telling them NO and saying it's policy worked fine.
     
  7. RxVampire

    RxVampire PharmDruggist

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    Fill @ midnight (good consistent fill Hx) for the regulars if they request or you predict to see him/her @ 12:01am. Then just by 10am/standard time for next day schedules. Use your judgment (not all settings are alike)

    I see no problem with others defaulting to standard time/company policy (might be a hassle arguing with some veteran patients if you are new though..."but so and so would fill @ midnight").
     
    Last edited: Sep 13, 2017
  8. maria1oh

    maria1oh 7+ Year Member

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    Tell them the system is down or offline.
     
  9. sosoo

    sosoo 7+ Year Member

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    this is clearly a blanket refusal of sales on "all" narcotics. yet no one comes in here to argue and attack like the way they argue against me in other threads. Lol.
     
  10. pharm B

    pharm B Phar Noir Moderator Emeritus Lifetime Donor 7+ Year Member

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    Somedays I'm glad I don't work in a 24 hour setting. Honestly, though, I'd probably just fill it at midnight. What's 8 hours?
     
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  11. Dr Wario

    Dr Wario Hey you! Want to try this pill? 5+ Year Member

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    Best way to fix your addicts that do this kind of stuff is to use cumulative refill too soon, problem solved.
     
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  12. trailerpark

    trailerpark 2+ Year Member

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    Maybe a massive amount of pain patients show up at 12am?


    Sent from my iPhone using SDN mobile app
     
  13. BJNCNC

    BJNCNC 7+ Year Member

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    Before I was a PIC I worked overnights. All scripts could be picked up at 7 am. We originally would let them pick up at 12a but the ER would send dozens of patients until 1 am and you can't help them when filling 20 narcotics. It's best to fill them at 3 am after the rest of the readyfill then verify readyfill.


    Sent from my iPhone using SDN mobile
     
  14. quickpic007

    quickpic007

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    when i did graves, regulars get service at 12A
    new patients get told 2 hour wait because the 12A regulars showed up on time (1130PM)
     
  15. owlegrad

    owlegrad Uncontrollable Sarcasm Machine Staff Member SDN Administrator 7+ Year Member

    My 12am clients were almost always super nice. They understood that I prioritized people from the ER and never gave me any grief if they had to wait a bit. I did consider instituting a rule about them having to come at a certain time but ultimately it just seems pointless. Whatever time I gave them they would have shown up right then anyway so what's wrong with midnight?
     
    pharm B and Charcoales like this.
  16. wagrxm2000

    wagrxm2000 2+ Year Member

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    This is rather simple, meet with the rxm and come up with how many days early and time. What's the worst that could happen they get upset and yell at you for a minute? They will move on to a different pharmacy or learn their times.

    It's real interesting after being at a store, you know all the patients that fill on the same days with each other.
     
  17. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    One of the few great things about CVS...corporate has a policy for how early you can fill. And the system won't let you fill it early without a deluge of overrides.
     
  18. CetiAlphaFive

    CetiAlphaFive

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    ... how is telling someone to wait 8 hours a refusal in any sense of the word refusal?
     
  19. Apotheker2015

    Apotheker2015 2+ Year Member

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    It's simple. If you're working at CVS, you're likely busy and have a steady flow of patients from the ER. The ER people bring you a script and you just fill it. You will see people going to the ER after an "injury" that happened after an early fill was denied. You can put two and two together. They took too many too often and ran short and now they need to resort to that to get a script to bridge the until their next fill is due. I said you just fill it because they had the courtesy to protect your license by going to the ER for the script. Sounds horrible but it comes down to that.

    Now maintenance pain management? There is no reason why you should have a line of 40 people at midnight demanding their ocycodone "refill". Sure, it will go through at midnight but a human has to run that claim. Then it has to be filled and checked by a pharmacist. All that takes time and people simply won't understand that.

    Add to that the wildcard that insurance companies update their systems at different times of the night and there is no way to know when. So you really can't guarantee you'll deliver at midnight.

    Besides those "refills" are ALSO 3 days early. Thus, not only are those maintenance meds but on top of it, theyre getting it early as a courtesy from us which they will disregard and grow to feel entitled to. No, why deal with any of it? Just say they will Be ready for pick up by 8am.

    Print out a sign stating something like "due to our high volume and in order to better assist you, C-II prescriptions scheduled to be filled bla bla bla will be ready for pick up at 8qm. Everyone has to be on board. Otherwise, you'll get complaints.

    It can't happen overnight either. You will get complaints. I did it over a month. I printed that statement and stapled it to bags etc. people were informed.

    But then again, that's my two cents. Sure, I made exceptions here and there but getting rid of the line at midnight allowed me to do my work.
     
  20. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    Why would you do that? Then they all come in at 8AM and make what is already a busy time even busier.
     
    owlegrad likes this.
  21. mikejones123

    mikejones123 2+ Year Member

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    1. They won't come back at 8AM....these are drug addicts....8 hours is like an eternity to them....they will just drive around to every 24 hour pharmacy in the state until one fills it

    2. I worked overnight, it was hell every night until I said maintenance narcotics can be picked up on the date due at 8am. All of a sudden all the 12 AM drug addicts disappeared and none drop off scripts to come back at 8am. Made life alot easier. I could start on readyfills the minute it dropped.

    3. I know some would wonder, that isnt the loss of narc scripts going to lessen your job security. At CVS, scripts and job security are generally independent. Proximity to competitors gives more job security than a higher script count. Couple years ago CVS got rid of alot of 24 hour stores that did a lot more scripts than my 24 hour store, yet my store still remains 24.

    4. Try this out. It will help your workflow and make life alot easier.
     
    PharmDminus likes this.
  22. Dred Pirate

    Dred Pirate 2+ Year Member

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    i worked overnights at the only 24 hour pharmacy in town - 2 blocks from a crazy busy large ED (academic medical center type of place). in a not so nice neighborhood I never had a line of people at midnight - this was 10 years ago, so maybe things have changed. The system reboots from 12-1215 or 1230 -I would just tell them that, and fill them when it rebooted, but I never had more than 1 or 2 times a week where I would have the "do not fill until date xxx" people show up.
     
  23. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    I don't really find it that big of a deal in the first place.

    Though to be fair, there aren't many of them at my new location. My old 24 hour store was so bad that they would fight each other over who was there first and who got their script filled first at 12:01AM. That amused me more than annoyed me.
     
    RxVampire likes this.
  24. Bubba98

    Bubba98 2+ Year Member

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    You don't need to explain why the policy is you just say it's your stores policy. I've been doing this a long time and allowing patients to drop off post dated narcotics to fill and have ready the next day at Xam is the only way to go.
     
  25. Old Timer

    Old Timer SDN Advisor SDN Advisor 10+ Year Member

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    You do realize post dated Narcotic Scripts are Illegal
     
  26. Bubba98

    Bubba98 2+ Year Member

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    I love snark. Allow me then to clarify old timer. Narcotics with correct date written but a do not fill stamp on them.
     
  27. Old Timer

    Old Timer SDN Advisor SDN Advisor 10+ Year Member

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    Clarity and precision are important..... You said Post Dated and I foolishly took you at your word.....

    [​IMG]
     
  28. Bubba98

    Bubba98 2+ Year Member

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    Post fill date and post written date but point taken. And yes you are the king.
     
  29. zelman

    zelman 7+ Year Member

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    You do realize all post-dated scripts are illegal
     
  30. Old Timer

    Old Timer SDN Advisor SDN Advisor 10+ Year Member

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    I do, but we were speaking of Controls so I answered that way,,,,,,
     
  31. Apotheker2015

    Apotheker2015 2+ Year Member

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    The pharmacy will be fully staffed at 8am or at least, it should be. There is no reason for the overnight pharmacist to deal with that. Heck, I didn't.
     
  32. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    lmao. No.
     
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  33. RxVampire

    RxVampire PharmDruggist

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    Hah, yeah 1 tech trying to do cycle counts and 1 RPh fiddling around WLM/"the hub" simultaneously whilst getting phone calls every 3 minutes and consistent flow of pick up and drive through. Not real productive.

    Tell them 9:05am if it's CVS, that's when all the overnight texts hit followed by the massive amount of phone calls asking "what's filled?" Use judgment
     
  34. Apotheker2015

    Apotheker2015 2+ Year Member

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    Every pharmacy is different. What has worked at yours, does not be come a golden rule for all other 24 hour locations. Let's not forget that at one point your location was one of many 24 hour locations that was converted to regular hours or extended hours. Clearly corporate realized pharmacists did not have enough to do in order to justify their wages and being open 24 hours. Hence, you were out of a job for a while. Maybe you were not one of them. I do not have time to go back and scroll through threads now. I do know several frequent contributors were out of a job for a while.

    OP's case is different. It is obvious that the influx of people asking for their "refills" on maintenance pain meds is interfering with OP's ability to get his job done. CVS never had an issue with me promising those fills after 8am. Truth is they never showed up at 8am. It was way inconvenient for them.

    You can LMAO all you want but we can all agree that any CVS pharmacy is better staffed at 8am than through the overnight shift. OP is going to do what makes sense to him.
     
  35. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    I got 1 tech and about 13 times as much stuff to do at 8AM including waiters and acutes vs nothing to do but readyfills at midnight...which can be put off until later. What workflow at flipping midnight does it disrupt? I've worked in pretty much every degree of overnight pharmacy from a 1500 store to a 7500 store and its all pretty much the same. You really don't have THAT MUCH to do at midnight. ER scripts, maybe, depending on the location. And if that's the case, tell them to come back later. Let's be honest...people just find these patients annoying and don't want to deal with them. Which is fine, too, I don't care. Just don't make up a bunch of nonsense. Just say you tell them to come back later because they annoy you.
     
  36. Apotheker2015

    Apotheker2015 2+ Year Member

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    Again, your experience is all of a sudden the golden rule. When I worked overnights, all I did until 2am was cleanup the mess that the evening people had left behind. I do mean 30+ pages of red. So I had plenty to do and did not always have an overnight tech. The latest that tech ever stayed was 1 or 2am.

    If someone shares an experience different than yours, your default shouldn't be that it is a bunch of made of nonsense. Maybe you should consider that you did have it easy when you worked overnights and that isn't the case everywhere. That is why there are still stores that are open 24 hours. And we all know the reason those stores are open 24 hours is not to cater to people refilling their pain meds 3 days early. C-IIs do not count toward your script count. To CVS if you 80 of those in one night and that's all you did. Then you did not do anything.
     
  37. wagrxm2000

    wagrxm2000 2+ Year Member

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    This right here.

    Haven't worked at a 24 hour pharmacy in years (no point), does telling them you fill the day it's due not work anymore?
     
  38. Apotheker2015

    Apotheker2015 2+ Year Member

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    Most people want to show up right at midnight and it throws a wrench on the workflow of the overnight pharmacist who already has enough nonsense to deal with.
     
  39. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    If it's someone you've never seen before, they have to wait because its corporate policy that you need to verify. That's a no brainer. But if you've got a regular customer that comes every month...why make them go through the hassle? They are waiting. You take care of them. It doesn't matter if you have 30 pages of red. I've walked into that, too. Been there, done that. Are those people in your waiting room? No. You are just pushing work onto the dayshift. Again, you just don't want to deal with them. Which, again, is fine. I'm not judging you on that at all. Just don't make up a bunch of nonsense excuses as to why you can't do it is all I'm saying. Just be honest.
     
    Last edited: Sep 16, 2017 at 12:37 PM
  40. wagrxm2000

    wagrxm2000 2+ Year Member

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    So, no it doesn't?
     
  41. Apotheker2015

    Apotheker2015 2+ Year Member

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    The expectation is that those 30 pages of red are gone by 8am. Yes, in some districts here I was told many times "that's what the overnight pharmacist is here for". There are many things that need to be done and prioritized. Refilling the scriptpro. The day shift would not touch it to the point that they would tell patients they were out of stock when in reality the scriptpro was empty and "the overnight rph is supposed to refill it".

    So no, I am not making up a "bunch of nonsense". Your experience and mine were clearly different. You did not see me nit picking your post and claiming that your experience was a bunch of made up nonsense. Instead, I thought "sure, he likely worked at a much slower store and didn't have to deal with that many C-II scripts to begin with". The whole "that's a bunch of made up nonsense" is likely something you've been saying since kindergarten when your narrow view of reality fails to explain the question at hand.
     
  42. Apotheker2015

    Apotheker2015 2+ Year Member

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    The issue is not the date. The issue is the time.
     
  43. RxVampire

    RxVampire PharmDruggist

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    Yeah, overnights are expected to be magicians making all ques clear on top of all the maintenance work. Still producing stuff that should have been done during your sleep even after midnight...Begs the question what the hell do daytime actually do besides phone calls? Yeah, if scriptpro stuff isn't replenished daytime people will just OOS it not even bothering to look at the shelves. Yep 10am standard time it is
     
  44. Apotheker2015

    Apotheker2015 2+ Year Member

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    THANK YOU!!! Daytime staff becomes very lazy and complacent when they have an overnight pharmacist. Where I worked, they would not even wash their own dishes after compounding or take out their own trash. "The overnight RPH will do it". I quickly put an end to that. The way I see it, we all walk by the dumpster on our way out. That was a lot of nonsense.
     
  45. wagrxm2000

    wagrxm2000 2+ Year Member

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    So no it doesn't work anymore?
     
  46. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    On days that are like that, if you don't do that CII now, then they have to do it in the morning. Whatever you don't do, they have to do. So you aren't really solving anything but shuffling around the work you don't feel like doing. It's impossible to get 30 pages plus Readyfill done by yourself. If whoever is expecting you to do that doesn't know that then they are an idiot. And you have to be exaggerating if 30 pages of red scripts is your typical night. I get that pharmacies have periods in which there is a **** staff situation where this becomes the norm for like a month or so. We've all been there. I walked into a store that was at over 50 pages one time. If that's your typical night for a sustained amount of time, WTF is wrong with your PIC, supervisor, and regional manager?

    Look, I've worked at the entire gamut of night shift pharmacies. It's what I do. Literally the busiest on the entire East Coast (which honestly wasn't too bad) to the one an hour and a half away from Philly that had 4 techs quit the same week and 50 pages when I walked in to one that only got 5 pages of Readyfill at midnight. There isn't a truly justifiable reason to not fill a CII for a regular, problem free patient that wants to wait at midnight other than you just don't feel like it. Just like there isn't a reason to not fill an antibiotic from the ER at midnight for a patient that wants to wait.
     
    Last edited: Sep 16, 2017 at 7:55 PM
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  47. WVUPharm2007

    WVUPharm2007 "Bubs Depot!" 10+ Year Member

    Your daytime people actually do compounds? I haven't seen a dayshift pharmacist at a 24 do a compound other than magic mouthwash in my entire life.
     
    RxVampire likes this.
  48. Apotheker2015

    Apotheker2015 2+ Year Member

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    Like I said on a previous entry, you do not set the after 8am rule from one day to another. If done properly, it can take a good 3 months for you to reach everyone your pharmacy regularly sees. The store I was referencing was a disaster. That PIC was shipped elsewhere. To find that many red pages was the rule until I turned into an @$$ and wouldn't let the evening pharmacists go home until they got the queue caught up. I left after a few weeks. That was nonsense.

    Did I break my own rule and fill for some people? Sure, I did. Of course, but I could have also spent every night doing just that -filling C-IIs for people who should probably have 15 additional tablets at home after getting so many extra early fills. It was so many of them that had I not set the after 8am rule, I wouldn't have been able to get anything done - like filling the scriptpro.

    Sure, whatever you don't do, the dayshift has to do. But that's exactly my point. Over here they're or were notorious for being lazy. They were on the phone all day. I would walk into pages that were red from 10am. So then WTF did they do all day? So if they have more staff why should the overnight pharmacist be the one to carry the cross?

    That stupid PIC. That PIC would say they had to always start the day on a blank slate. All queues had to be empty. HUH??? That dumb F-tard still working for CVS.
     
  49. wagrxm2000

    wagrxm2000 2+ Year Member

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    This is too funny, most pharmacists I know would laugh in your face if you tried to not let them leave.
     
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  50. doublehh03

    doublehh03 Senior Member 10+ Year Member

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    Don't know if serious. I"m a manager at a 24 hour store. I have covered my gy shifts during summer or flu season. Please don't compare daytime to gy. It's night and day. And no, most 24 hour stores aren't fully staffed at 8am. My store has a tech at 7:30am, and the next one is 9am. We have to be fair to the night team and stick a tech until 1130-12am for the gy too.

    Now if your day team doesn't clear queue, then talk with your pic and let them know they have to do their job. Day time clears their queues, night time clears theirs.
     
  51. Apotheker2015

    Apotheker2015 2+ Year Member

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    Well, it worked. I guarantee you that those pharmacists are not the kind to leave pages and pages of pending orders for the overnight pharmacist.
    I would laugh at anyone who would try to prevent me from leaving but mostly because I don't leave stuff behind for others to clean up either.
     

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